Workplace Safety and Insurance Law

The employer appealed a case manager's decision classifying an injured EMS worker as a volunteer, which had resulted in her earnings being set at the statutory maximum.

The Appeals Resolution Officer found that despite the 'volunteer' label used by the employer to comply with the Ambulance Act, the true nature of the employment relationship under the Workplace Safety and Insurance Act was that of a part-time casual on-call employee.

The worker was required to be on-site for 24-hour shifts rather than responding from home.

Consequently, the worker's loss of earnings rate was ordered to be recalculated based on actual earnings, with the resulting overpayment deemed non-recoverable.

The worker's widow appealed a decision denying her request for reimbursement of airfare for her daughter, son-in-law, and two grandchildren to travel from the USA to Ontario for the worker's funeral.

The worker had passed away from compensable mesothelioma.

The Appeals Resolution Officer denied the appeal, finding that the Workplace Safety and Insurance Act does not provide for the reimbursement of expenses incurred by individuals other than the worker or spouse.

The worker suffered a gradual onset of bilateral wrist tendonitis from typing and using a computer mouse at work.

She continued to work with accommodations but her condition worsened.

Her treating practitioners recommended a two-week absence from work to rest and allow the inflamed tendons to heal.

The WSIB initially denied full loss of earnings (LOE) benefits for this period, concluding she could have continued on modified duties.

On appeal, the Appeals Resolution Officer allowed the worker's objection, finding that rest was an acceptable and necessary form of treatment given the circumstances, and granted full LOE benefits for the two-week period.

The employer objected to the initial allowance of a worker's claim for a back injury sustained on April 20, 2007, arguing there was insufficient proof of accident due to delayed reporting and medical attention.

The worker, a construction worker, injured his back while lifting steel joists but did not report it until April 26, 2007, and sought medical attention on April 30, 2007.

The Appeals Resolution Officer found the worker's explanation for the delay reasonable, noting the injury was initially thought to be a minor strain that worsened with continued work.

The officer concluded that proof of accident was established and denied the employer's objection, confirming the initial allowance of the claim.

The worker, a ski instructor and Alpine race coach, suffered bilateral knee injuries in a workplace accident.

The WSIB initially provided loss of earnings (LOE) benefits and labour market re-entry (LMR) services, but discontinued them after a medical report suggested the worker could return to his pre-injury employment with a knee brace.

The worker objected, arguing he could not perform the physical demands of his pre-injury jobs.

The Appeals Resolution Officer found that the worker could not return to his pre-injury employment due to the risk of further injury and inability to perform advanced ski instruction.

The worker was granted full LOE benefits from the date they were discontinued, resumption of LMR services, and continuation of his physiotherapy program.

The request for weight loss and strength training programs was denied.

The worker, who suffered bilateral blindness due to a 1970 workplace accident, requested entitlement to a specialized wide band radio receiver costing $14,550 as an independent living device.

The worker argued the device was necessary to access local and international news and talk radio independently.

The Appeals Resolution Officer denied the request, finding that the worker already had access to local and international news via his existing VHS/UHF radio, computer, and the internet, and that the requested radio would be a duplication of services.

The worker suffered a work-related right knee injury in 2006 and subsequently underwent a total knee replacement in 2008.

The WSIB initially denied entitlement for the surgery, concluding it was for a pre-existing osteoarthritic condition rather than the compensable injury.

The Appeals Resolution Officer allowed the worker's appeal, finding that the compensable injury permanently aggravated the underlying osteoarthritis, which progressed post-accident, bringing the total knee replacement within the scope of entitlement.

The worker appealed the denial of initial entitlement for a low back injury allegedly sustained while filling drill holes with emulsion at a quarry.

The worker claimed a specific accident occurred when pulling a jammed hose, but the Appeals Resolution Officer found inconsistencies in the worker's reporting and a lack of medical evidence corroborating a work-related accident history.

The worker had a pre-existing history of back pain and failed to report the injury to the employer or seek immediate medical attention.

The objection was denied, and the denial of initial entitlement was upheld.

The worker objected to the quantum of a 15% permanent impairment award for a lower back injury sustained in 1984.

The worker argued the award did not adequately recognize the level of disability.

The Appeals Resolution Officer reviewed the medical evidence, including a May 2009 reassessment and reports from the attending physician, and found the objective clinical findings were consistent with a 15% award.

The worker's objection was denied.

The worker objected to a decision setting the arrears date for his increased permanent disability award to September 12, 2007.

The worker had originally suffered a low back injury in 1970 and received a 10% permanent disability award.

Following a reassessment, his award was increased to 20%.

The Appeals Resolution Officer reviewed the medical evidence and found that a specialist report from September 18, 2006, demonstrated a significant permanent deterioration in the worker's condition.

Applying WSIB policy, the officer allowed the objection and adjusted the arrears date to June 18, 2006, three months prior to the specialist report.

The worker appealed a decision denying entitlement for multiple chemical sensitivity (MCS) allegedly caused by workplace exposure to fumes and chemicals.

The worker initially claimed the exposure aggravated his pre-existing Hepatitis C, but later claimed it caused MCS.

The Appeals Resolution Officer found that the worker's symptoms resolved when he was removed from the exposure and that he refused the employer's offers of accommodation, including a self-contained breathing apparatus and a new position with no fume exposure.

Medical evidence did not support a causal relationship between the workplace and the claimed MCS.

The appeal was denied.

The worker, an industrial cleaner, suffered a back injury after slipping and falling at work.

The WSIB initially denied Loss of Earnings (LOE) benefits for the period of July 29, 2008 to August 25, 2008, concluding the worker was not totally disabled and modified duties were available.

The worker appealed.

The Appeals Resolution Officer allowed the appeal, finding that the medical evidence demonstrated the worker was in the acute phase of recovery and totally disabled during that period.

The worker was following his physician's instructions not to return to work, thereby complying with his obligations under the Workplace Safety and Insurance Act.

The worker objected to a decision denying entitlement to a January 2006 recurrence of a right shoulder injury and associated loss of earnings (LOE) benefits.

The worker originally injured her shoulder in 2003 and underwent surgery, later returning to modified work at a courtesy desk.

She claimed the modified work exacerbated her condition, leading to further disability.

The Appeals Resolution Officer found that the deterioration of the worker's shoulder condition, including the progression of pre-existing acromioclavicular joint symptoms, was a consequence of the work-related injury and subsequent surgery.

The modified job was deemed unsuitable, and the worker was awarded full and partial LOE benefits.

The employer objected to the denial of Second Injury and Enhancement Fund (SIEF) cost relief regarding a worker's claim for a right inguinal hernia.

The worker developed the hernia after lifting heavy castings at work.

The employer argued that the worker's pre-existing conditions, including a prior groin strain, prostate cancer, and other medical issues, contributed to the hernia or prolonged recovery.

The Appeals Resolution Officer found insufficient evidence that any pre-existing condition contributed to the onset of the hernia or prolonged its recovery, noting the heavy lifting at work was sufficient to be the primary cause.

The employer's request for SIEF relief was denied.

The employer appealed the allowance of Loss of Earnings (LOE) benefits to the worker for the period of October 5, 2006 to February 6, 2007.

The worker, a federal employee, had sustained a compensable right knee and hip injury but later developed a non-compensable psychological condition.

The Appeals Resolution Officer found that LOE benefits were properly paid until December 12, 2006, as the worker remained partially impaired physically and no bona fide job offer was available.

However, benefits from December 13, 2006 to February 6, 2007 were rescinded because the worker's inability to participate in return-to-work measures during that period was due solely to the non-compensable psychological condition.

The employer's appeal was granted in part.

The worker, a letter carrier, suffered a compensable injury in November 2004 after slipping on ice.

He returned to modified and then full duties.

In November 2005, he claimed a recurrence of his injuries after experiencing pain while delivering mail on a new route that required carrying a heavy satchel.

The WSIB initially denied the recurrence claim.

On appeal, the Appeals Resolution Officer found that continuity of medical treatment had been established and that the new job duties constituted an insignificant new accident that temporarily aggravated his compensable injuries.

The worker's objection was allowed.

The worker objected to the suitability of the Suitable and Available Employment or Business (SEB) of Private Investigator and the earnings used to calculate his Future Economic Loss (FEL) benefits at the first and final reviews.

The Appeals Resolution Officer found that the SEB was appropriate and within the worker's physical restrictions, which remained unchanged despite an increase in his Non-Economic Loss (NEL) quantum.

The Officer also determined that the earnings used to calculate the FEL benefits were appropriate and in accordance with applicable policies, noting the worker's failure to mitigate his wage loss after relocating.

The worker's objections were denied.

The worker appealed a decision denying him full loss of earnings (LOE) benefits and entitlement for psychotraumatic disability following a 2002 workplace injury to his left shoulder and right hip.

The Appeals Resolution Officer found that the worker's physical restrictions did not render him totally unemployable, as he had successfully completed truck driving training and was capable of light delivery work.

Regarding the psychotraumatic disability claim, the Officer concluded that the workplace injury was only a minor contributing factor to the worker's depression, which was primarily driven by multiple non-compensable psychosocial stressors.

The appeal was dismissed.

The employer objected to the allowance of initial entitlement for a low back injury and the payment of full Loss of Earnings (LOE) benefits from December 24, 2008, due to a recurrence.

The Appeals Resolution Officer found that the worker suffered a compensable unaccustomed strain to the low back due to delivering mail in snowy conditions.

The Officer also upheld the recurrence, finding that the worker was totally disabled and unable to perform the modified work offered by the employer after December 24, 2008.

The employer's objection was denied, and LOE benefits were upheld up to May 5, 2009, when a non-compensable heart condition arose.

The worker suffered a right leg laceration at work in June 2004.

Over a year later, the worker claimed entitlement for a right knee meniscus tear, arguing it was related to the original accident or a premature return to work.

The Appeals Resolution Officer denied the objection, finding that medical evidence from the time of the original injury showed no knee joint involvement and that the subsequent meniscus tear was not causally related to the workplace accident.